- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT05906017
Open Versus Robotic-assisted Ventral Hernia Repair, Short and Long-term Outcome
June 23, 2023 updated by: University of Southern Denmark
In this randomized clinical trial, the investigators will compare the conventional open repair for hernia in the anterior abdominal wall with the robotic-assisted approach.
110 patients with midline abdominal wall defects will be randomized to either open or robotic-assisted surgery.
The investigators will examine short and long-term complications through follow-up with clinical assessment as well as patient-reported outcome measures including pain, cosmetic appearance, and overall patient satisfaction.
Furthermore, the investigators will study the difference in surgical stress response between the two methods measured from a variety of different biomarkers before and after the operation.
A cost-effective analysis will be conducted for the robotic and open procedure.
Study Overview
Status
Recruiting
Conditions
Intervention / Treatment
Detailed Description
Ventral hernias occur in up to 25% of the population.
They are diverse in severity ranging from small umbilical hernias to large abdominal wall defects that may result in loss of domain.
Approximately one-third are incisional hernias.
Incisional hernias are usually more complex due to complications from previous surgery.
The procedure may be complicated as a result of intraabdominal bowel adhesions and adhesions within the hernial sac.
These factors cause discomfort and may complicate the repair.
Ventral hernias may be repaired either through a minimally invasive laparoscopic procedure or an open approach.
The laparoscopic repair was introduced in the 1990s and in 2003 the first robotic-assisted procedure was described in a porcine model.
In 2012 the first series of robotic repairs were reported in humans.
Due to the superior flexibility of the robotic instruments, there is a substantial interest in harnessing the advantages of the robotic platform.
Because robotic repair differs in several technical aspects from the open approach, it is important to determine whether the short and long-term results differ between the two procedures.
Furthermore, it remains unresolved whether the robotic procedure is able to provide comparable outcomes to the open repair when assessed for quality-of-life outcome measures.
These questions are important to address in order to determine the most appropriate surgical options for individual patients.
Study Type
Interventional
Enrollment (Estimated)
110
Phase
- Not Applicable
Contacts and Locations
This section provides the contact details for those conducting the study, and information on where this study is being conducted.
Study Contact
- Name: Kristian Als Nielsen
- Phone Number: +45 79 97 00 00
- Email: Kristian.Als.Nielsen3@rsyd.dk
Study Contact Backup
- Name: Michael Festersen Nielsen
- Phone Number: +45 79 97 00 00
- Email: Michael.Festersen.Nielsen@rsyd.dk
Study Locations
-
-
Southern Denmark
-
Aabenraa, Southern Denmark, Denmark, 6200
- Recruiting
- Sygehus Sønderjylland
-
-
Participation Criteria
Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.
Eligibility Criteria
Ages Eligible for Study
- Adult
- Older Adult
Accepts Healthy Volunteers
No
Description
Inclusion Criteria:
- Age≥18
- ASA 1-3
- Clinical and radiologic diagnosis of primary midline ventral hernia
- Eligible to surgery according to a preoperative anaesthetic assessment
- Informed consent
- Able to understand written and oral Danish language
Exclusion Criteria:
- Incarcerated ventral hernia requiring emergency surgery
- Pregnancy
- Patients with chronic pain due to arthritis, migraine or other illness requiring regular intake of analgesics (paracetamol, NSAID, opiates etc).
- Current cancer diagnosis
- Previous laparotomy
- History of psychiatric or addictive disorder that prevents the patient from participating in the trial
- Co-existing inflammatory disease
- Co-existing immunological disease that requires medication of any kind
- BMI >35 kg/m2
Study Plan
This section provides details of the study plan, including how the study is designed and what the study is measuring.
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Active Comparator: Open repair
Open ventral hernia repair
|
primary midline ventral hernia repair - open
|
Experimental: Robotic-assisted repair
Robotic-assisted ventral hernia repair
|
primary midline ventral hernia repair - robotic
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Change in satisfaction and quality of life
Time Frame: From inclusion until 6 months after operation.
|
Satisfaction and quality of life were measured preoperatively at the outpatient clinic using the "abdominal hernia questionnaire" (AHQ) translated into Danish.
The AHQ has 4 possible answers (All of the time, Most of the time, Some of the time, None the time OR Strongly disagree, Somewhat disagree, Somewhat agree, Strongly agree OR Very unsatisfied, Somewhat dissatisfied, Somewhat satisfied, Very satisfied)
|
From inclusion until 6 months after operation.
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Operating time
Time Frame: Time from first incision to wound closure
|
Measured in minutes
|
Time from first incision to wound closure
|
Length of hospital stay
Time Frame: From inclusion and until six months after surgery.
|
Length of hospital stay measured in days from admission to discharge.
|
From inclusion and until six months after surgery.
|
Change in Surgical stress response (CRP)
Time Frame: measured at baseline preoperatively, 30 minutes after extubation, 120 minutes after extubation and on day 1 and 3.
|
The degree of systemic inflammatory response expressed by C- reactive protein in serum
|
measured at baseline preoperatively, 30 minutes after extubation, 120 minutes after extubation and on day 1 and 3.
|
Hernia defect size
Time Frame: Measured preoperatively
|
Hernia defect size measured in mm either on CT scan or intraoperative.
|
Measured preoperatively
|
Intraoperative need of blood transfusion
Time Frame: From first incision until last suture has been placed
|
The amount of blood transfused during surgery measured in mL
|
From first incision until last suture has been placed
|
Change in surgical stress response (Interleukins)
Time Frame: Measured at baseline preoperatively and up until 120 minutes after extubation on day 1 and 3.
|
The degree of systemic inflammatory response expressed by cytokine levels in serum.
All measurements will consist of weight/volume ratio (eg.
CRP mg/L and IL-6 pg/mL)
|
Measured at baseline preoperatively and up until 120 minutes after extubation on day 1 and 3.
|
Treatment cost
Time Frame: From inclusion until 6 months postoperatively
|
Cost analysis of the two types of treatment
|
From inclusion until 6 months postoperatively
|
Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Sponsor
Investigators
- Study Director: Michael Festersen Nielsen, Hospital of Southern Denmark - Aabenraa
Study record dates
These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.
Study Major Dates
Study Start (Actual)
May 15, 2023
Primary Completion (Estimated)
May 15, 2025
Study Completion (Estimated)
May 15, 2025
Study Registration Dates
First Submitted
May 23, 2023
First Submitted That Met QC Criteria
June 7, 2023
First Posted (Actual)
June 15, 2023
Study Record Updates
Last Update Posted (Actual)
June 26, 2023
Last Update Submitted That Met QC Criteria
June 23, 2023
Last Verified
June 1, 2023
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- SHS-MT Kir-2-2023
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
NO
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
No
Studies a U.S. FDA-regulated device product
No
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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